The inspection took place on 23 and 29 June 2016. The visit was announced which meant that the registered manager was given 48 hours’ notice. This was to help facilitate the inspection and make sure that people who used the service and staff members were available to talk with us. At our last inspection on 12 February 2014 the service was found to be meeting the required standards in the areas we looked at. Home Instead Senior care St Albans is a domiciliary care service that provides care and support to up to sixty people in their own homes.

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. The registered manager was supported by service and assistant service managers responsible for the day-to-day operation of each location where people received care and support.

People told us that staff helped them stay safe, both at home and when out and about in the community. Staff received training for how to safeguard people from abuse and were knowledgeable about the potential risks of abuse and how to report their concerns. Robust recruitment practices were followed and there were sufficient numbers of suitable staff available at all times to meet people’s needs. People where necessary and appropriate were supported to take their medicines safely and at the right time by trained staff. Potential risks to people’s health and well-being were identified, reviewed and managed effectively.

People who received support, relatives and health care professionals were positive about the skills, experience and abilities of staff who received training and refresher updates relevant to their roles. Staff supported people to maintain good health and access health and social care services when necessary.

Staff obtained people’s agreement to the support provided and always obtained their consent before helping them with personal care and were aware of MCA requirements. People told us that staff supported them in a kind and caring way that promoted their dignity. We found that staff had developed positive relationships with the people they supported and were clearly very knowledgeable about their needs and personal circumstances.

People who received support were involved in the planning and regular reviews of the care provided and this was accurately reflected in their individual plans of care. The confidentiality of information held about people’s medical and personal histories was securely maintained.

People received personalised care and support that met their needs and took account of their preferences. Staff were knowledgeable about people’s background histories, preferences and routines. People were supported to pursue social interests relevant to their needs. They told us that the registered manager and staff listened to them and responded positively to any concerns they had. People were encouraged to raise any concerns they had and knew how to make a complaint if the need arose.

People, their relatives, staff and professional stakeholders were all complimentary about the management team and how the service operated. The management team monitored the quality of services and potential risks in order to drive continuous improvement.